Risk Assessment Practices Among Home Visiting Nurses and Child Protection Caseworkers in Colorado, United States: A Qualitative Investigation




Venice Ng Williams, Roman Ayele, Suzuho Shimasaki, Gregory Jackson Tung, and David Olds

Brief Type

Journal Publication


  • Nurse-Family Partnership (NFP)


Nurses and caseworkers engage in assessments with the families they serve. Nurse home visitors from Nurse-Family Partnership (NFP) improve maternal-child health outcomes with first‐time low‐income mothers through care, education and support. In the United States, Child Protective Services (CPS) are state‐level governmental agencies that protect children, including responding to reports of child maltreatment. This paper aimed to characterize similarities and differences in risk assessment practices between NFP nurses and CPS caseworkers in Colorado, United States. Using a grounded theory approach, we conducted in‐depth qualitative interviews with 112 NFP and CPS workers from seven Colorado NFP sites from 2013 to 2015. Study sites were purposefully selected based on size, structure, geography and degree of collaboration with CPS. We conducted interviews first with NFP sites and used snowball sampling to recruit CPS workers. Interviews were recorded, transcribed, validated and then coded in NVivo 10. Memo writing was conducted to organize and link concepts within the theme of risk assessment. NFP and CPS workers emphasized the importance of risk assessment in their respective practices. Although there were similarities in the types of risks assessed, we found variations in work processes, operational definitions and methods of risk assessment between the two organisations that impacted inter‐organisational collaboration to serve high‐risk mothers and their children. NFP and CPS workers may have different roles and responsibilities but their underlying goals are the same – to keep children and their families safe and healthy. By understanding these similarities and differences in practice, there lies potential to improve collaboration between home visiting programs and child welfare to provide integrated service delivery of high‐risk families and prevention of future child maltreatment. (author abstract)

Data Collection Methods

  • Interviews



For More Information

Williams, V. N., Ayele, R., Shimasaki, S., Tung, G. J., & Olds, D. (2019). Risk assessment practices among home visiting nurses and child protection caseworkers in Colorado, United States: A qualitative investigation. Health & Social Care in the Community, 27, 1344–1352.
doi: https://doi.org/10.1111/hsc.12773
Author Contact Information:
Venice Ng Williams


  • Collaboration and Coordination